Context: Previous studies have suggested that infections are an important cause of death in patients with Addisons disease, but epidemiological studies on the frequency of infections in this population are scarce.

Design and setting: We conducted a cohort study, using data from the Dutch PHARMO record linkage system, linking patients demographics and medical histories to the use of prescription drugs, diagnostic and therapeutic data from hospital and general practitioner records.

Participants: From a cohort of oral glucocorticoid users, 390 patients with Addisons disease were identified by assessing concurrent use of glucocorticoids and mineralocorticoids using pharmacy dispensing records. A reference cohort (n=1933) with the same age and sex distribution was sampled from patients not using glucocorticoids.